You would have often heard doctors urge patients to stick to the antibiotic dosage and duration prescribed. Have you ever wondered why they are so intent upon this?

It is because overuse or misuse of antibiotics can lead to bacteria becoming resistant to antibiotics, or in other words, they develop antibiotic resistance. Many people believe that their body has become resistant to the antibiotic. This is not true. It is the bacteria that develop resistance.

Antibiotic resistance is part of a bigger area called antimicrobial resistance or AMR. Here, it is not just bacteria but viruses, fungi, etc. also which become resistant to the drug used to fight them. As a result, infections become more difficult to treat. In the long run, this results in infections spreading faster, increasing in severity and sometimes unfortunately resulting in disability and death.

Antimicrobial resistance is a natural process for the pathogens – they evolve to become resistant. But the misuse and overuse of antimicrobials by people result in accelerating the process.

While it is true that there is more than one antibiotic to treat a bacterium, it is important that doctors have options to choose from. Also, trying to find an antibiotic that works results in valuable time being lost and the following unnecessary complications may ensue:

• Increased duration of illness
• Side-effects due to stronger medicine use
• Extended hospital stay
• Increased medical expenditure

Antibiotic resistance is a global concern and a multi-pronged approach is required to handle it. Making people aware is one of the main components of this approach as this will help people protect themselves and their loved ones.

Causes of Antibiotic Resistance

There are many reasons as to why a prescribed antibiotic may not work.

Antibiotic Overuse:

• When we self-diagnose and take antibiotics when they are not needed, it can lead to antibiotic resistance.
• For example, most cases of sore throats are due to viruses. Antibiotics do not work against viruses.
• If people, without consulting a doctor, start treating themselves with antibiotics when they are not needed, it contributes to antibiotic resistance.

Antibiotic Misuse:

• If after being prescribed antibiotics, we do not take them as directed and miss a few doses or stop them too soon, the bacteria can multiply and mutate.
• The mutated bacteria will be resistant to the antibiotic and as a result, there will be infection remnant in the body even after the antibiotic course is over.

Spontaneous Resistance:

• In certain cases, the DNA of the bacterium changes naturally.
• In such cases, the antibiotic prescribed will not target the mutated bacterium.
• Or alternatively, the mutated bacterium will be able to oppose the antibiotic.

Transmitted Resistance:

• It is possible for an antibiotic-resistant infection to be transmitted among people.
• As a result, those people will have an infection that does not respond to an antibiotic.
• While there will be another antibiotic that can be used, the resistant bacteria will become more difficult to treat.

Who Is at Increased Risk of Antibiotic-Resistant Infections?

While all are at risk of antibiotic-resistant infections, certain people are at increased risk. These include:

• Babies, especially premature ones
• Older adults (> 65 years)
• People who live in crowded conditions
• Immunocompromised people

Combating Antibiotic Resistance

While healthcare leaders and policymakers are working to combat this problem, there are things that the common man can do as well.

► Maintain Good Hygiene:

• Yes, something as simple as washing our hands well can play a big role in this fight against antibiotic resistant infections.
• By washing hands and observing other basic hygiene practices, we can protect ourselves from infections.
• This means that the need for antibiotics for treatment is eliminated.
• When as a society, we stop using antibiotics, we reduce the probability of bacteria becoming resistant to antibiotics.

► Use Antibiotics Only When Absolutely Necessary:

• At times, the symptoms for viral and bacterial infections may be the same.
• This leads to people wrongly assuming an infection to be bacterial and as a result, they start self-treating themselves with antibiotics.
• It is imperative to consult a doctor before starting any antibiotic.

► Get Vaccinated:

• Do talk to your doctor about vaccination.
• While most antibiotic-resistant bacteria do not have vaccines yet, some (like the pneumococcal vaccine) are available and they play an important role in preventing bacterial infections.
• Vaccines for flu should also be taken.

Antimicrobial Resistance – A Global Issue

• The antimicrobial drugs that we have developed are important tools in our arsenal to fight infections. The rise in antimicrobial-resistant infections jeopardizes our ability to treat infections and carry out important procedures like cancer treatments, joint replacement procedures, etc.
• When people are affected with antimicrobial-resistant pathogens, treatments are long-drawn and sometimes even hospitalization is required. This affects the person’s finances. Caregivers too are affected financially and when we take a look at the bigger picture, healthcare systems and the whole country’s economy suffer.
• It is not just humans that are affected by antimicrobial-resistant pathogens. Plants and animals too are impacted. This reduces farm productivity and puts food security at risk.
• AMR is a problem that has no borders. People and countries are affected irrespective of income levels.

It is important that this is viewed as a global issue and steps are taken at the grassroot level to address it. This includes:

• Ensuring access to clean water, sanitation and hygiene
• Prioritizing prevention of infections
• Ensuring vaccines’ accessibility and affordability
• Forming and enforcing relevant legislations

How Do Doctors Treat Antibiotic Resistance?

The options available to treat antibiotic-resistant bacteria are limited. The doctor may opt for an advanced antibiotic or may decide on a combination of antibiotics.

Carbapenems, antibiotics that are effective against resistant bacteria, may be prescribed. The pros and cons of the treatment will be explained.

The research for better options continues but, in the meanwhile, it is important that the common people too do their part in the fight against antimicrobial-resistant infections.

Frequently Asked Questions

1. What is antibiotic resistance?

Antibiotic resistance is when bacteria become resistant to antibiotics, making infections harder to treat.

2. What causes antibiotic resistance?

Resistance is caused by overuse or misuse of antibiotics, such as taking them unnecessarily or not completing a prescribed course.

3. Who is most at risk for antibiotic-resistant infections?

Babies, older adults, people in crowded conditions, and those with weakened immune systems are most at risk.

4. How can we prevent antibiotic resistance?

Prevent it by practicing good hygiene, using antibiotics only when necessary, and getting vaccinated.

5. How are resistant infections treated?

Doctors use stronger or combined antibiotics to treat resistant infections, but options are limited.

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